Responding to Higher-Than-Expected Infant Mortality Rates from Respiratory Syncytial Virus (RSV): Improving Treatment and Reporting Strategies

Dvorkin, Julia; Luca, Julián De; Álvarez-Paggi, Damián; Caballero, Mauricio T.

doi:10.2147/idr.s373584

Cited by 7 publications

(6 citation statements)

References 86 publications

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“…Given the possibility of upcoming preventive measures, it is imperative to estimate the cost of illness (COI) for long-term wheezing outcomes associated to a previous severe ALRTI due to RSV in LMIC 4 . This is of utmost importance for several compelling reasons.…”

Section: Introductionmentioning

confidence: 99%

“…Respiratory Syncytial Virus (RSV) is a ubiquitous pathogen that poses a considerable threat to infants and young children globally, causing millions of hospitalizations due to acute lung infection and more than 100,000 deaths every year [1][2][3][4] . More than ninety percent of the fatal cases associated with this virus occur in contrasting settings of low-and middle-income countries (LMICs) 5 .…”

Section: Introductionmentioning

confidence: 99%

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Assessing the Long-Term Economic Impact of Wheezing Episodes After Severe RSV Disease in Children from Argentina: A Cost of Illness Analysis

Dvorkin,

Pecenka,

Sosa

et al. 2024

Preprint

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Introduction. There is a lack of available data on the economic burden of wheezing episodes resulting from prior severe respiratory syncytial virus (RSV) infections in resource constrained settings. This study aimed to assess the cost incurred for wheezing episodes during five years after a severe RSV infection in children from Argentina, considering both the public health system and societal perspectives. Methods. A prospective cohort was conducted to assess the cost-of-illness (COI) linked to wheezing episodes after severe RSV disease in children from Buenos Aires, Argentina. Direct medical and non-medical costs were estimated, along with indirect costs per episode and patient. Data pertaining to healthcare resource utilization, indirect expenses, and parental out of pocket costs were obtained from research forms. The overall cost per hospitalization and health visits were calculated from the perspectives of the healthcare system and society. Costs were quantified in US dollars. Results. Overall, 150 children aged between 12 and 60 months presented a total of 429 wheezing episodes. The median number of wheezing episodes per patient was 5 (IQR 3 to 7). The mean cost per wheezing episode was US$ 191.01 (95% confidence interval [CI] $166.37 to $215.64). The total cost per episode of wheezing was significantly higher (p<0.001) in infants under 12 months of age (207.43, 95%CI 154.3-260.6) compared to older toddler subgroups. The average cumulative cost associated to wheezing per patient was US$ 415.99 (95%CI $313.35 to $518.63). Considering both acute RSV disease and long-term wheezing outcomes the cumulative mean cost per patient was US$ 959.56 (95%CI $832.01 to $1087.10). Conclusions. This study reveals the economic impact of prolonged wheezing resulting from severe acute RSV infection on Argentina's public health system and society. The estimates obtained serve as valuable inputs for informing cost effectiveness analyses of upcoming RSV preventive interventions.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessing the Long-Term Economic Impact of Wheezing Episodes After Severe RSV Disease in Children from Argentina: A Cost of Illness Analysis

Dvorkin,

Pecenka,

Sosa

et al. 2024

Preprint

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“…FDA has recently approved for US a vaccine for use in women during the middle of the third trimester of pregnancy to protect their babies against RSV up to 6 months after birth 16 . Moreover, many other vaccines and immune therapeutics technologies are also under clinical development and evaluation for children 17,18 .…”

Section: Introductionmentioning

confidence: 99%

“…In the scenario of new preventive interventions ahead, estimating the cost of illness (COI) for ALRTI due to RSV in LMICs is critical for several reasons 17 . First, most of the severe cases and deaths occur in these countries, where urgent implementation of preventive interventions is needed to diminish the impact of RSV disease.…”

Section: Introductionmentioning

confidence: 99%

Cost of illness due to Respiratory Syncytial Virus Acute Lower Respiratory Tract Infection Among Infants Hospitalized in Argentina

Dvorkin,

Sosa,

Vodicka

et al. 2023

Preprint

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Background. Information is scarce regarding the economic burden of respiratory syncytial virus (RSV) disease in low-resource settings. This study aimed to estimate the cost per episode of hospital admissions due to RSV severe disease in Argentina. Methods. This is a prospective cohort study that collected information regarding 256 infants under 12 months of age with acute lower respiratory tract infection (ALRTI) due to RSV in two public hospitals of Buenos Aires between 2014 and 2016. Information on healthcare resource use was collected from the patient’s report and its associated costs were estimated based on the financial database and account records of the hospitals. We estimated the total cost per hospitalization due to RSV using the health system perspective. The costs were estimated in US dollars as of December 2022 (1 US dollar = 170 Argentine pesos). Results. The mean costs per RSV hospitalization in infants was US$587.79 (95% confidence interval [CI] $535.24 – $640.33). The mean costs associated with pediatric intensive care unit (PICU) admission more than doubled from those at regular pediatric wards ($1,556.81 [95% CI $512.21 – $2,601.40] versus $556.53 [95% CI $514.59 – $598.48]). Conclusions. This study shows the direct economic impact of acute severe RSV infection on the public health system in Argentina. The estimates obtained from this study could be used to inform cost-effectiveness analyses of new preventive RSV interventions being developed.

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“…A measurement of health utilities is also necessary for cost-effectiveness analyses, and significant development in preventive strategies may currently be observed, including monoclonal antibodies and novel vaccine candidates; thus, with the growing number of prophylactic measures as well as possible therapeutic strategies, a detailed assessment will require data on the benefits, and the benefits might reach out far beyond the sole protection against the disease [ 30 , 31 , 32 , 33 ]. The rationale underlying this study is the identification and evaluation of parental QoL challenges related to RSV hospitalization.…”

Section: Introductionmentioning

confidence: 99%

The Estimate of Parental Quality of Life Loss Due to Respiratory Syncytial Virus (RSV) Hospitalization

Wrotek,

Jackowska

2023

Diseases

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Background: Respiratory syncytial virus (RSV) is one of the leading causes of pediatric hospitalizations, mainly in children under 2 years of age. Hospitalization affects the caregivers’ quality of life (QoL). We assessed the caregivers’ QoL during RSV-confirmed hospitalizations of children under 2 years old, identified the most affected QoL dimensions and calculated utilities focusing on the assessment methods and potential confounders. Methods: The caregivers filled out the EQ-5D questionnaire, consisting of a descriptive system (assessing 5 QoL dimensions) and a visual analog scale (EQ VAS). Utility, utility loss and quality-adjusted life years (QALY) loss were calculated, and a concordance between the two systems was assessed. Results: A disturbance in any of the five assessed dimensions was reported by 42% (55 out of 132) of the caregivers, mostly anxiety/depression (37%) and pain/discomfort (17%). The utilities varied between 0.17 and 1 in the descriptive system and 0.33–1 (median 0.86) in the EQ VAS, with a utility loss of 0.14 (IQR: 0.1–0.2). The calculated QALY loss reached a median of 2.45 × 10−3 (IQR: 1.37 × 10−3–4.56 × 10−3) and was not influenced by the patient’s age or the final clinical diagnosis (QALY loss for bronchiolitis: 2.74 × 10−3, pneumonia: 1.84 × 10−3, bronchitis: 1.78 × 10−3, differences statistically insignificant). Only a moderate concordance between the descriptive system and the EQ VAS was seen (Spearman’s rank correlation coefficient = 0.437, p < 0.05), with the latter revealing a higher degree of QoL disturbances. Conclusions: RSV hospitalization influences parental QoL significantly, and anxiety/depression is the most commonly reported issue. Utility impairment scores depend on the assessment method but not on the patient’s age or final diagnosis. Thus, the impact of RSV on caregivers’ QoL cannot be underestimated.

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Responding to Higher-Than-Expected Infant Mortality Rates from Respiratory Syncytial Virus (RSV): Improving Treatment and Reporting Strategies

Cited by 7 publications

References 86 publications

Assessing the Long-Term Economic Impact of Wheezing Episodes After Severe RSV Disease in Children from Argentina: A Cost of Illness Analysis

Assessing the Long-Term Economic Impact of Wheezing Episodes After Severe RSV Disease in Children from Argentina: A Cost of Illness Analysis

Cost of illness due to Respiratory Syncytial Virus Acute Lower Respiratory Tract Infection Among Infants Hospitalized in Argentina

The Estimate of Parental Quality of Life Loss Due to Respiratory Syncytial Virus (RSV) Hospitalization

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